By: Elta Mariani
Representative Jeffrey Sánchez has served as the Massachusetts State Representative for the 15th Suffolk District since 2003. In February 2015, he was appointed the House Chairman of the Joint Committee on Health Care Financing. Prior to this role, he served as the House Chairman of the Joint Committee on Public Health.
Representative Sánchez’s overall legislative agenda is driven in large part by the issues faced in his district– access and retention in education, public infrastructure development, workforce development, public health, and affordable housing. His healthcare work is focused on evidence-based health policy reform, particularly for underserved communities. He has worked to pass comprehensive reforms on compounding pharmacy practice and school nutrition programs, as well as expanded public health data sharing, enhanced practice for nurse midwives, and was instrumental in several key provisions of Chapter 224, the 2012 Massachusetts health care cost-containment law.
Before running for the House of Representatives, Sánchez worked in the Boston Mayor’s Office from 1995 to 2001. Prior to this work, Sánchez worked in San Diego as a financial management advisor and investment banker. He earned his Bachelor of Arts Degree in Legal Education from the University of Massachusetts, Boston, a Masters of Public Administration from the John F. Kennedy School of Government at Harvard University and is a current instructor at the Center for Public Health Leadership at the Harvard University TH Chan School of Public Health.
1. What drew you to politics?
My mother was a community activist, and her area of focus was housing. We moved to Boston when I was a small child and lived in a housing project down the street from Harvard and Children’s Hospital. My mother was troubled by the Boston Housing Authority- its bureaucratic nature, how it treated people, and its failure to help many people find opportunities. She organized people, planned community meetings, was the head of a housing task force, and even sued and won against the Housing Authority (Perez v. BHA). Boston was a different city then. It was in decline. Now, the community where I grew up is thriving. My mother made some friends but her drive often challenged people, which I did not like when I was young. It wasn’t until later that I appreciated her activism and embraced public service myself.
2. You have an MPA from Harvard. How has that helped you in your current role?
I attended the program after 15 years of government and finance work had left me feeling tired and defeated, and it became vocational training for me. The Kennedy School intellectualized things I had been working on. It helped me refine fundamental knowledge that I already had. Also, it put me in contact with the folks who are leading authorities. I initially wanted to work for a mutual fund company, but I managed to meet with Mayor Thomas Menino, and 20 years later here I am.
3. How do you balance the agendas of various interest groups? Attorneys at firms have a duty of loyalty to their clients, and in-house attorneys to their companies, but as a legislator, don’t you have a duty to the entire public?
I listen to people. I ask enough probing questions until I get at what people really want. Then, I weave their ideas together and try to hopefully build something that people at opposite ends can appreciate and own together as opposed to holding on tightly to what they think is the solution. I have been a stock broker and an investment banker- I am done with selling. Now I am dealing with the business of people, and it is all about bringing people together for the goal of the public good. One of the biggest issues is poverty. Boston is cleaner, prettier, and more modern today, but it is still a challenging city for a lot of people.
My most valuable class from the Harvard Kennedy School was taught by Brian Mandell. It was a sort of “negotiations bootcamp” that helped me compartmentalize the challenges involving state and local finance, infrastructure investment, math and public policy, and accountability. We would work on things and then go over in class the pieces that would help make the best value for people.
4. Tell me about the Joint Committee on Health Care Financing.
I was appointed to the committee in late February, and I had previously served on the Committee of Public Health for 6 years. In this prior experience I learned about how the government tries to address health in a group setting, and the mechanics of this setting (aka, how the delivery system operates). I worked on initiatives such as regulating compounding pharmacy and drugs and rewriting the determination of need statute to include market impact (region and Commonwealth as a whole) in Chapter 224. I worked with finance on the public payer side, MassHealth, and members of various communities. Some major issues were primary care, workforce issues, and insurance card use. I learned how to look at the healthcare system within the overall market economy, and ask what are things that impact it and how can we remedy certain issues.
Since healthcare reform began in 2006, these have continued to be big issues. 37% of the state budget is spent on healthcare in one way or another. Medicaid is $15 billion and growing. This matters because the economy health is linked to healthcare. Healthcare comprises 11-12% of the economy. The committee’s goal is to improve care delivery in a manageable and sustainable way.
5. About how many bills does the committee address on a regular basis? How does the process work?
We get bills referred to us from any of 5 other committees- Financial Services, Public Health, Mental Health and Substance Abuse, Children and Families, and Elder Affairs. We usually begin a legislative session with around 150 bills.
Bills also come from constituents. If you have a good idea, you could go to your representative and the bill will get filed. Then, a clerk looks at the bill and determines where it goes. I don’t get to choose bills. The clerk gives them to my committee. Then I work with my Senate counterpart and if the bill gets traction, we will rewrite it until it is approved.
6. Do bills often reflect changes occurring in surrounding states? For example, this summer Connecticut enacted new hospital legislation that seems to dissuade mergers, and New Hampshire enacted a paid sick time law. Does the committee actively watch such developments?
I have a fantastic research staff that makes sure everything I need to know crosses my desk. My staff is comprised of people with many different backgrounds including public health, business, and law.
7. What is your view on elections and short terms for state representatives? Do they tend to keep political goals in line with those of the general populace, or are they a distraction from making real changes, due to worries about continued constituent support?
Nah. Every 2 years your name is on the ballot. If people like you and you are doing the right thing, you will get re-elected. If not, you won’t. The world of politics changes a lot. The new generation looks at things completely differently. You used to be able to get strong messages out, but now with phones and laptops, people are no longer attending community meetings. But that doesn’t mean people are not informed. As a politician, you need to put yourself into the new way of communicating to reach people. You still must hold on to fundamental strategies too, because people still go outside, but it is a balance.
8. What role do you see lawyers playing regarding these challenges? What role ought they to play?
Lawyers exercise the right to have representation in many forms. Also, the legal community is very well represented in public affairs. I can talk to the head of an institution or organization, but they will always have a legal team that they depend on. Yes, lawyers and politicians both get a hard time for sometimes aggravating problems, but who said representation was going to be easy? The world is more complicated now than ever before, and lawyers and politicians are needed.
Massachusetts is a very dynamic state when it comes to healthcare policy, delivery, finance, and writing the tomes. Members of the bar make the difference because they are actively improving how we do things.
9. Does the Open Meeting Law apply to you and if so, does it inhibit or aid decision-making?
The Open Meeting Law is pretty complicated. I can meet with people. Talking to people and learning from them is not covered. It is when I am making decisions that it matters. We have a public hearing on each bill (though the meeting to learn about it can be off-camera), where we incorporate co-chair comments and ask if there will be a motion to move the bill forward. Then if we get a motion, we talk to other members in a public meeting executive session before voting.
10. Tell me something interesting about you that people do not generally know (a “fun fact”).
I wanted to go to law school and actually applied to BU and Suffolk Law, but ultimately Harvard Kennedy School was the best option for me. Also, I think it is funny when people ask what my plan is. My plan is going and talking to people about their plans. The people who are underserved and underprivileged need a voice.
11. Is health care spelled as one word or two?
I usually spell it as one, but I think that it can be spelled either way. A piece of advice- always asks the question that you’re afraid to ask, because other people may be wondering the same thing.
Elta Mariani is a 3L student at Boston College Law. During law school, she has served as a president of the student-run Health Law Society, and worked at athenahealth, Tufts Medical Center, and the law firm of Donoghue, Barrett & Singal. She received her undergraduate degree from Cornell University.